End cap assembly for retractor and other medical devices

ABSTRACT

A medical device including a handle portion connected to an operative portion at a proximal end thereof, the handle portion having a hollow cross-section and an open distal end, an illumination assembly comprising at least one light source, a switch assembly for energizing the light source, and at least one battery for powering the light source, an end cap assembly configured to attach to the open distal end of the handle portion, the end cap assembly accommodating the switch assembly and being configured to hold the at least one battery within the handle and to partially enclose the at least one battery, and a smoke evacuation channel in communication with the hollow cross-section of the handle, wherein a portion of the switch assembly extends through an opening in the end cap assembly and the at least one battery is held by the end cap assembly to overlap with the switch assembly and to overlap with the opening in the end cap assembly, and wherein the end cap assembly includes a vacuum port configured to couple to a vacuum source and to provide suction to the smoke evacuation channel through the handle.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/869,994 filed on Jan. 12, 2018, which is a continuation-in-part ofU.S. patent application Ser. No. 15/495,371, filed on Apr. 24, 2017 andentitled “Retractor,” which is a continuation-in-part application ofU.S. patent application Ser. No. 15/171,581, filed on Jun. 2, 2016 andentitled “Retractor,” which claims priority to U.S. Provisional PatentApplication Ser. No. 62/170,280, filed on Jun. 3, 2015, and entitled“Surgical Instrument” and to U.S. Provisional Patent Application Ser.No. 62/258,806, filed on Nov. 23, 2015, and entitled “Retractor.” Theentire contents of each of those applications are incorporated herein byreference.

INTRODUCTION

Embodiments described herein relate to surgical instrumentation and,more particularly, a retractor providing an integrated light source androunded blade, forming an unobstructed, illuminated viewing slot for thephysician's field of view.

Light sources that interfere with the physicians field of view, or thatdo not properly illuminate the field of view, inhibit the physician fromseeing critical developments. For example, when performing a dissection,potential blood sources may drain blood into the dissection cavity, andwithout proper treatment, these blood sources can cause post-surgeryinfection. Such concerns are pertinent when using breast retractors,which are used for breast augmentation or reconstruction.

Conventional breast retractors may cause blood to drain into thedissection cavity due to a lack of proper illumination in the field ofview.

Currently, breast retractors require substantial auxiliary lighting.This lighting is expensive, difficult to assemble, requires cleaning andreprocessing after each use, and due to lack of customization for breastretractors, fails to provide sufficient light at desired locations.Namely, practitioners must assemble and secure an independent lightsource onto the breast retractor prior to the patient procedure. Theseauxiliary light sources do not provide the physician with the ability tofocus the light onto, and illuminate, specific portions of the surgicalfield without interfering with the physician's field of view.

Further, auxiliary light sources affixed to a retractor requireexpensive preparation and components that must be reprocessed after eachpatient procedure in order to ensure no patient cross-contamination.Without adequate reprocessing, cross contamination from one patient toanother can occur. Moreover, even with reprocessing of the lightsources, effective reprocessing is not 100% guaranteed, and manyhospitals have reported patient cross-contamination due to inadequate orerrors in reprocessing.

Therefore, as can be seen, there is a need for a retractor providing anintegrated light source and rounded blade forming an unobstructed,illuminated viewing slot for the physician's field of view.

One exemplary aspect comprises an illuminated surgical retractor,comprising: a blade having a top surface and a bottom surface; a handleextending at an angle from a proximal end of the blade; a curved sectionconnecting the handle to the blade; and an illumination assemblycomprising at least one light source, at least one battery and anactivation device for energizing the light source, and the illuminationassembly being permanently attached to the retractor; wherein the blade,handle, and curved section are molded from a glass-fiber reinforcedpolymer.

One exemplary aspect comprises an illuminated surgical retractor,comprising: a blade having a top surface and a bottom surface; a handleextending at an angle from a proximal end of the blade; a curved sectionconnecting the handle to the blade; and an illumination assemblycomprising at least one light source, at least one battery and anactivation device for energizing the light source, and the illuminationassembly being permanently attached to the retractor; wherein the blade,handle, and curved section are molded from a low conductivity polymer.

One exemplary aspect comprises an illuminated surgical retractor,comprising: a blade having a top surface and a bottom surface; a handleextending at an angle from a proximal end of the blade; a curved sectionconnecting the handle to the blade; and an illumination assemblycomprising at least one light source, at least one battery and anactivation device for energizing the light source, and the illuminationassembly being permanently attached to the curved section; wherein theblade, handle, and curved section are molded from a radiolucent polymer.

In various embodiments: (1) the polymer is a 50% glass-fiber reinforcedpolymer; (2) the polymer is a polyarylamide compound; (3) the polymer isa thermoplastic crystalline polymer; (4) the polymer is a thermoplasticcrystalline polymer of aromatic diamines and aromatic dicarboxylicanhydrides; (5) the polymer is a glass-fiber reinforced polyarylamide;(6) the polymer is at least 50% glass-fiber reinforced; (7) the polymerhas a flexural modulus of at least 17 Gpa; (8) the polymer has aflexural strength of at least 375 Mpa; (9) the polymer has an impactstrength of at least 100 J/M; (10) the illumination assembly ispermanently attached to the curved portion; and/or (11) the polymer hasa conductivity of less than 10-6 A.

Further features and advantages will be apparent to those skilled in theart after reviewing the drawings and detailed description providedherein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of an exemplary embodiment;

FIG. 2 is a dimetric view of an exemplary embodiment;

FIG. 3 is an exploded view of an exemplary embodiment;

FIG. 4 is a perspective view of an exemplary embodiment;

FIG. 5 is a rear view of an exemplary embodiment;

FIG. 6 is a perspective view of an exemplary embodiment, with the lightassembly removed for clarity;

FIG. 7 is a front view of an exemplary embodiment;

FIG. 8 is a top view of an exemplary embodiment;

FIG. 9 is a bottom view of an exemplary embodiment;

FIG. 10 is a top view of an exemplary embodiment;

FIG. 11 is a front angled view of an exemplary embodiment;

FIG. 12 is a rear view of an exemplary embodiment;

FIG. 13 is a side perspective view of an exemplary embodiment;

FIG. 14 is a top perspective view of an exemplary embodiment;

FIG. 15 is an inverted view of an exemplary embodiment;

FIG. 16 is a side perspective view of an exemplary embodiment;

FIG. 17 is a rear perspective view of an exemplary embodiment;

FIG. 18 is a top perspective view of an exemplary embodiment;

FIG. 19 is a side view of an exemplary embodiment;

FIG. 20 is a side view of an exemplary embodiment;

FIG. 21 is a view of an exemplary embodiment;

FIG. 22 is another view of an exemplary embodiment;

FIG. 23 is a fluoroscopy image illustrating the radiolucency of anembodiment;

FIG. 24 illustrates flexural strength and flexural modulus for a varietyof plastics;

FIG. 25 is another view of an exemplary embodiment;

FIG. 26 is another view of an exemplary embodiment;

FIG. 27 is another view of an exemplary embodiment;

FIG. 28 is another view of an exemplary embodiment, with a light/smokeevacuation cover removed;

FIG. 29 depicts an end cap assembly of an exemplary embodiment;

FIG. 30 is another view of an end cap assembly of an exemplaryembodiment;

FIG. 31 is another view of an end cap assembly of an exemplaryembodiment;

FIG. 32 is a perspective view of a first exemplary embodiment;

FIG. 33 is a perspective view of a second exemplary embodiment;

FIG. 34 is a perspective view of an end cap assembly in accordance witha further embodiment including a releasable battery door;

FIGS. 35A-35B are internal views of the end cap assembly of FIG. 34including a battery assembly and an activation switch.

FIGS. 36A-36B are views of a portion of the end cap assembly of FIG. 34showing alignment between the battery assembly, the activation switchand a releasable battery door;

FIG. 37 is another perspective view of the end cap assembly of FIG. 34with the releasable battery door removed to expose the activationswitch;

FIG. 38 is an internal view of the releasable battery door of the endcap assembly of FIG. 34 with the activation switch;

FIG. 39 is a perspective view of an end cap assembly in accordance witha further embodiment including an end cap port;

FIG. 40A-40B are internal views of the end cap assembly of FIG. 39 withadditional features for providing an air tight seal;

FIG. 40C shows a battery assembly and an activation switch housed by theend cap assembly of FIG. 39 ;

FIG. 41 is a side view of the end cap assembly of FIG. 39 showing alatch for locking with a retractor handle;

FIG. 42 is a partial view of a retractor handle showing an opening forreceiving the latch from an end cap assembly; and

FIG. 43 is a cross-sectional view the end cap assembly of FIG. 39coupled to a retractor handle to create an air tight seal.

DETAILED DESCRIPTION OF SELECT EXEMPLARY EMBODIMENTS

The following detailed description is of certain exemplary embodiments.The description is not to be taken in a limiting sense, but is mademerely for the purpose of illustrating the general principles of thepresent retractor.

Broadly, one or more embodiments provide a surgical retractor includingan integrated light source and rounded blade forming an unobstructed,illuminated viewing slot for the physician's field of view. The surgicalretractor with integrated light source prevents the problem caused byexternal light sources—namely, the casting of shadows within theoperating cavity. To solve this problem, the integral light source ofthe surgical retractor is pointed in the same direction as the distalend of the retractor, which causes the light to be directed to the samepoint where the cutting is being performed.

The surgical retractor may provide a handle portion generallyperpendicularly joined to a blade portion. The blade portion may form anarcuate (curved) shaped barrel portion defining a viewing slot, whereinthe blade portion interconnects a saddle portion and an operativeportion. The operative portion is dimensioned and adapted for surgery.The saddle portion attaches to the handle portion, while forming arecessed cavity for receiving the light source. The light source andrecessed cavity are disposed, dimensioned, and adapted so that the lightbeam from the light source is directed down the viewing slot.

Referring now to FIGS. 1 through 22 , one or more exemplary embodimentsmay include a surgical retractor 100 integrated with a light assembly205. The surgical retractor 100 may include a handle portion 110generally perpendicularly joined to a blade portion 120. The handleportion 110 may be joined to the blade portion 120 at saddle portion210. The blade portion 120 may extend from a proximal end 130 to adistal end 140, wherein the proximal end 130 is joined to the handleportion 110 at saddle portion 210.

The blade portion 120 may be made of any moldable material that issufficiently resilient including, but not limited to, polystyrene,poly-carbonate, glass filled nylon, or the like, although as explainedherein, glass-reinforced polyarylamide is preferred, due its superiorstrength, radiolucency, and low conductivity.

The blade portion 120 may form a saddle portion 210, a barrel portion215, and an operative portion 220.

The blade portion 120 may extend from the proximal end 130 to the distalend 140, wherein the barrel portion 215 interconnects the saddle portion210 and the operative portion 220.

The barrel portion 215 may form an arcuate shape along its length sothat the trough of the arcuate shape is upwardly oriented, defining a“viewing slot,” as illustrated in the drawings.

The saddle portion 210 may be formed in a bowl-like configuration. Thesaddle portion 210 may form a recessed cavity 605 for receiving thelight assembly 205. A spring or other fastener (not shown) may beprovided to secure the light assembly 205 in the recessed cavity 605.

The light assembly 205 may include a light source 305, a switch 310 anda power source 315 connected in series. The power source 315 may includebatteries, such as button style batteries, adapted to store onlysufficient energy for a single use. Alternatively, the batteries may bereusable or rechargeable batteries for multiple uses. The light source305 may be enclosed by a housing 320. The light source may include aLED, OLED, incandescent, or other suitable light source for emitting abeam of light. The switch 310 may be a light tab made from anonconductive material, such as a Mylar tape, adapted to open circuitthe serial electrical circuit of the power source 315 and the lightsource 305, whereby removal of the switch 310 results in the powersource 315 activating the light source 305. In certain embodiments, theswitch 310 may utilize any known means of activating/powering the lightsource 305, such as, but not limited to, a push button switch, toggleswitch, magnetic reed switch or slider switch.

The recessed cavity 605 and the light source 305 may be dimensioned andadapted so that the beam of light is directed along the viewing slot,toward the distal end 140 of the blade portion 120, as illustrated inFIGS. 2 and 6 , which illustrate the light source 305 disposed in thesaddle portion 210 and directed down the viewing slot of barrel portion215. As shown, the housing 320 is disposed below the viewing slot, andtherefore out of the field of view of the end user.

The operative portion 220 may be downwardly angled away from the viewingslot so as to not obstruct the above-mentioned field of view. Theoperative portion 220 may be substantially flat and/or substantiallysquare or rectangular in shape, providing a distal tip with a pluralityof ridges 710 opposite the barrel portion 215. The shape of the distaltip and the ridges 710 may be dimensioned and adapted to hold the tissueof the breast recessed cavity away from the area of dissection, whichhelps the end user in the dissection procedure. Ridges 710 may be of anysuitable depth and size in order to hold the breast tissue.

A method of using the retractor may include the following. The surgicalretractor 100 disclosed above may be provided. A user may remove thesurgical retractor 100 from a sterile package just prior to the surgicalprocedure. The user may remove the switch 310 to energize the lightsource 305. The user may then create an incision in the patient and usethe surgical retractor 100 to create a pocket through this incision. Thepocket will be used for breast augmentation, reconstruction, or otherbreast related surgical procedures. When the procedure is over, theretractor 100 may be discarded, because the light source 305 may bedesigned to not be replaceable and the power source may only besufficient to power the light source for a single procedure, therebyallowing disposal of the present embodiment after one use.

In certain embodiments, the surgical retractor 100 can be adapted toform a retractor suitable for other procedures such as a nasal retractorspine retractor, orthopedic retractor, and retractors for other surgicalprocedures. All such retractors maintain the present embodiment of fullyassembled, lighted, and single use.

In certain embodiments, the retractor may be used in a medical procedureperformed by robots. Such robots will also need lighted retractors toallow visualization of the surgical cavity. Robotic procedures alsobenefit from enhanced field of view, and from single use components thateliminate the risk of patient cross contamination. An embodiment willcontain suitable connecting features for attachment to a medical robot.

FIGS. 10-22 depict embodiments comprising a retractor 100 with a lightsource 1020 located toward or near the distal end 140 of the barrelportion 215. It should be noted that some or all of the features asdiscussed herein with reference to these embodiment may be used inconjunction with, or in place of, some or all of the features inembodiments previously disclosed.

Referring now to FIGS. 10-20 , retractor 100 may include a light source1020 located nearer to the operative portion 220. The light source 1020may be located toward the distal end of barrel portion 215. Light source1020 may be located at any point near the distal end 140, includingwithin the barrel portion 215 and the operative portion 220.

Light source 1020 may include a wide dispersion angle, such as a 100degree angle, or any suitable variation thereof. The wide dispersionangle may be attained by using a wide dispersion LED. The use of lightsource 1020, with a wide dispersion angle, and its location toward thedistal end 140 of the blade portion, provides light to the entireoperative area located in front of operative portion 220.

As illustrated in FIG. 10 , the light source 1020 may be associated withsome or all of the features of light assembly 205, including lightsource 305, a switch 310 and a power source 315.

Further, in this embodiment, operative portion 220 may include integralridges 710, shown in FIG. 13 , which provide for holding back tissueduring use of the retractor 100.

A smoke evacuation channel 1105, with channel cover 1010, is locatedwithin barrel portion 215, and may extend, at one end, up to operativeportion 220. In some embodiments, the smoke evacuation channel 1105 andcover 1010 may extend into a portion of the operative portion 220 at oneend. The channel 1105 may be a hollow cavity defining the barrel portion215.

At a second end, the smoke evacuation channel cover 1010 may be anchoredin the saddle portion 210. The smoke evacuation channel 1105 may thenextend into a hollow space located within handle 110. Thus, handle 110may include a hollow space for receiving the smoke evacuation channel1105 and cover 1010.

As illustrated, the smoke evacuation channel cover 1010 may be angled atcertain points. The smoke evacuation channel 1105 may also incorporatelight source 1020. Light source 1020 may further include a light holder1115.

Channel 1105, coupled with cover 1010, provided for air and smoke toenter channel 1105 via a gap between cover 1010 and the barrel portion215, thereby guiding smoke away from the physician's field of view. Thegap may be provided on either side of the light source 1020.

The smoke channel 1105 and cover 1010 may extend from the distal end 140of the retractor 100, near the operative portion 220, towards handle110, as shown in FIG. 14 .

Channel 1105 conducts air or smoke received at the entrance of thechannel 1105, located at the distal end of the blade portion 120,towards the handle portion 110. Channel 1105 therefore acts as an airconduit and moves air/smoke away from the incision site and/or thephysician's field of view.

A vacuum source may be attached to the retractor 100. The vacuum sourcemay be connected to any point of the handle portion 110, including thebottom of the handle 110, distal to the saddle portion. Alternatively,the vacuum source may be attached at any suitable location to the handleportion 110, or may be attached directly to the cover 1010 at thelocation of the saddle portion 210.

The handle portion 110 may be hollow and act as an air conduit. Smoke orair may leave the channel 1105 at the entrance to the handle portion110, which may include a hollow chamber that is in communication withchannel 1105. The handle portion 110 may include a portion of channel1105, which is integral with the other portion of cover 1010.Alternatively, the handle portion 110 may include a second cover incommunication with channel 1105, and may receive the smoke/air fromchannel 1105. The vacuum source may be attached at the base of thehandle portion 110.

The vacuum source is operable to provide suction, via the channel 1105,in order to move air/smoke away from an incision site or the physician'sfield of view. The air/smoke enters the channel 1105 at an openingcreated by the gap between cover 1010 and barrel portion 215, locatednear the blade tip, traverses the channel 1105 toward the saddle portion210, and enters the handle portion 110. The vacuum source pulls theair/smoke from the handle.

As illustrated in the inverted view of the retractor 100 in FIG. 15 ,the channel 1105 and cover 1010 descend to the bottom 1520 of the handleportion 110. The cover 1010 includes a connector 1410 at the bottom1520, which fluidly connects the channel 1105 to the vacuum source anddraws the smoke/air out of the channel.

As illustrated in FIGS. 11-13 , the smoke channel 1105 advantageouslyabuts operative portion 220 in order to provide smoke evacuation fromthe operative site. Further, the light source 1020 may be provided at anangle similar to, or substantially the same as, the downward angle ofthe operative portion 220 relative to the barrel portion 215, in orderto focus the light from the light source 1020 onto the area retracted bythe operative portion 220.

The light source 1020 may alternatively be provided at an anglesubstantially similar to the barrel portion 215, and may not slopedownward with the operative portion 220. This may still cause the lightsource to illuminate the operative area, due to the wide dispersionangle of the light source 1020.

Yet further illustrated is the angle of the operative portion 220,particularly at the distal end as it slopes downward. Integral ridges710 provide, along with the angle of the blade 120 at its operativeportion 220 and the square shape of the operative portion 220, foroptimal methods and apparatus for holding back tissue during use.

Blade 120 may incorporate one or more retaining slots 1510, shown inFIGS. 15 and 17 , on the underside of the blade. The slots 1510 areoperable to hold cover 1010 in place. The retaining slots 1510 are alsooptimally designed to not catch tissue during a surgical procedure, suchas when the blade 120 is inserted into the body cavity.

Each retaining slot 1510 incorporates a hole sized to receive aretaining tab 1605 from cover 1010, as shown in FIG. 16 . To hold cover1010 in place on top of blade 120, the retaining tab 1605 from cover1010 is inserted into the hole of retaining slot 1510. Retaining slots1510 are sized such that the hole is smaller than the associatedretaining tab 1605. The hole is raised and smoothed, which holds bodytissue away from the hole.

As illustrated in FIG. 21 , retaining slot 1510 may include a raised andsmoothed portion. Based on this feature, the retaining tab 1605, wheninserted into and residing within retaining slot 1510, is recessedwithin the hole, and does not protrude from the hole of retaining slot1510. This ensures that no tissue is snagged or caught by the end ofretaining tab 1605.

FIG. 22 illustrates a cutaway of tab 1605 residing within, and notprotruding from, retaining slot 1510. Tab 1605 deforms around shelf2210, and tab 1605 snaps into place such that contact between theunderside of tab 1605 and the top of shelf 2210 prevents the separationof tab 1605 from shelf 2210.

Shelf 2210 is located opposite retaining slot 1510. Retaining slot 1510is located on the underside of blade portion 120, and is formed frommold structures that penetrate the blade portion 120 from the underside.The penetration of the mold structures forms holes in the blade portion120, such as retaining slot 1510, which is shown filled in with tab1605. To prevent retaining slot 1510 from trapping tissue, it ispreferable to minimize the size of retaining slot 1510, as well as limitthe number of holes to one hole located on the underside of bladeportion 120.

Retractor 100 is therefore formed using a mold structure that penetratesblade portion 120 only in the location of shelf 2210. The formed hole ofretaining slot 1510 is minimized in size to be of the same, orapproximately the same, size as the width of shelf 2210.

In an embodiment, the manufacturing process includes utilizing the moldstructures to form a hole in the underside of the blade portion (e.g.,in the hole of retaining slot 1510), opposite shelf 2210. By penetratingthe blade portion 120 only in the location of the shelf, and in no otherlocation on the underside of the blade portion, the hole on theunderside, which may face the patient during a procedure, is only aswide as the shelf. Thus, the hole size is reducing trapping of patienttissue.

Yet, by reducing the hole area for retaining slot 1510, and providingfor one hole the same width of shelf 2210, during manufacturing,retaining tab 1605 cannot deform into place to fit around shelf 2210.

As illustrated in FIG. 22 , an additional hole 2220 is therefore formedduring manufacturing from a mold structure on the top side of bladeportion 120, opposite the tissue-facing underside, in order to allow fordeformation of retaining tab 1605.

Hole 2220 is formed to provide for deformation of retaining 1605. Thelocation of hole 2220 is optimally located on the top side of bladeportion 120, away from tissue contact. Hole 2220 does not proceedthrough the width of the blade portion 120, thereby minimizingadditional hole structures on the patient-facing side of retractor 100.

As illustrated in FIGS. 21-22 , retaining slot 1510, is sized to halfthe width of a conventional hole, due to the use of multiple molds.Therefore, only slot 1510, with a smoothed mound, provides for minimaltissue catch.

In an embodiment, the retractor 100 is formed from an injection molddesign. It should be noted that a shrunken hole is smaller than theretaining tab 1605, which is only possible in an injection mold design,and is not feasible with a metal retractor.

Retractor 100 further includes an on/off switch 1705, located at thebottom of handle 110. Switch 1705 may be located adjacent to theconnector 1410. Switch 1705 controls one or more of the light source andvacuum source.

FIG. 18 illustrates the retractor 100 with cover 1010 removed. Channel1105, the cavity, under the smoke evacuation cover 1010, is illustratedextending from a distal end of the barrel portion 215 adjacent to theoperative portion 220, past the saddle portion 210, and into a cavity1810 located in the handle 110. Smoke may travel from the intakeadjacent to operative portion 220, under the cover 1010, via channel1105, into the handle cavity 1810. The smoke traverses the internalcavity 1810 and exits the handle via connector 1410, which is connectedto a smoke evacuation hose and uses suction from the vacuum source.

FIGS. 18-20 illustrate the electrical connection to the light source1020, which is normally held in place in channel 1105 by the smokeevacuation cover 1010. The wires 1820 lead from the light source 1020into a power source in the handle 110. The power source is controlled byswitch 1705. The power source may contain sufficient charge for only asingle use.

As illustrated in FIG. 19 , retractor 100 may include an assembly 1910.Assembly 1910 may be made or manufactured separate from the retractorbody. Assembly 1910 may be include one or more of a power source 1920,wires 1820, switch 1705 and light source 1020.

In an exemplary method of manufacture, assembly 1910 may be inserted, asone pre-formed piece, into the base portion of handle 110. Assembly 1910may be inserted into the cavity of handle 110 from the bottom, and fedup through handle 110, out the top portion of handle 110, adjacent tothe saddle portion 210. The assembly 1910 may then be placed onto thebarrel portion 215, within channel 1105, at which point the light source1020 and wires 1820 of assembly 1910 are placed into receiving slots1830. The cover 1010 is then placed over the channel 1105, includingassembly 1910, and snapped into place.

A method of utilizing the smoke channel 1105 to remove the smoke from aphysician's field of view may include the following. Generating smokeduring a surgery or procedure by, for example, use ofelectro-cauterization tools. This smoke may interfere with thephysician's vision, particularly with the field of view. The lightsource 1020 may be focused on the physician's field of view. During thecourse of the procedure, a vacuum source may be switched on, and smokemay be drawn into the retractor via the smoke evacuation channel. Thesmoke may traverse the smoke evacuation channel, into the handle, andout the bottom of the handle.

It should be noted that the entire retractor and associated componentsas disclosed herein, including the blade/handle, handle cover, andcover, are fully compatible with low-cost injection molding, and areable to be manufactured using low cost plastic. Further, the entireretractor assembly is optimal for use as a single-use and disposableproduct.

It should be understood that, among the advantages of the retractor, theneed for a separate smoke evacuation tool is eliminated. Additionally, abright light source is provided to illuminate the surgical cavity.

In an embodiment, the surgical retractor includes a handle portionjoined to a blade portion. The blade portion may be perpendicularlyjoined to the handle portion, such as at a 90 degree angle orapproximately 90 degree angle. In another embodiment, the blade portionmay be joined to the handle portion at any suitable angle, such as, forexample, a 30 degree angle, 45 degree angle, 110 degree angle or anyother suitable angle.

In an embodiment, the blade portion includes a saddle portion, a curvedbarrel portion, an operative portion, and a channel cover. The saddleportion abuts the handle portion, forming a recessed cavity. The curvedbarrel portion is located distal to the saddle portion and defines achannel. Within the barrel portion, a light assembly is disposed. Theoperative portion is located distal to, and downwardly angled from, thebarrel portion. The channel cover is disposed over the channel withinthe barrel portion, and is adapted to hold the light assembly in place.

In an embodiment, the operative portion of the retractor issubstantially squared in shape, and includes a plurality of ridgesdistal to the barrel portion. The ridges may be of any suitabledimension. The ridges may be dimensioned to grip tissue and hold thetissue away from an operative area.

In an embodiment, the light assembly abuts the operative portion andincludes a light source, a switch, a single-use power source, and ahousing.

In an embodiment, the channel of the retractor is a smoke evacuationchannel that extends from the barrel portion, through the saddleportion, and into a hollow space in the handle portion.

In an embodiment, the smoke evacuation channel extends through a lengthof the handle portion to a connector located at a bottom of the handleportion. A vacuum source may be coupled, via a connector, to the bottomof the handle portion. The coupling of the vacuum source provides afluid connection between the smoke evacuation channel and the vacuumsource, which provides suction for removing smoke.

In an embodiment, the surgical retractor includes a handle portion and ablade portion joined to the handle portion. The blade portion includes asaddle portion abutting the handle portion and forming a recessedcavity; a curved barrel portion located distal to the saddle portion anddefining a channel, the barrel portion including a light assemblydisposed within the barrel portion; an operative portion located distalto, and downwardly angled from, the barrel portion; a channel coverdisposed over the channel, within the barrel portion, and adapted tohold the light assembly in place, the channel cover including aplurality of retaining tabs; and a plurality of retaining slots locatedon an underside of the blade portion, the retaining slots sized tominimize a size of the hole of the retaining slot and including asmoothed and raised geometry to facilitate tissue movement withoutcatching. Each retaining tab is sized to fit into one of the pluralityof retaining slots, and the retaining slots operable to hold the channelcover in place over the channel.

Therefore, provided is a self-lighted retractor with the ability toprovide bright, shadow-less light to a surgical cavity. In accordancewith the invention, also provided is a dual-purpose smoke evacuationchannel and light source holder that couples the light source to theretractor. Further provided in accordance with the invention is asingle-use battery and high volume moldable plastic components thatallow for manufacture of a high-quality retractor that is affordable forsingle use, reducing infection risk. Yet further provided in accordancewith the invention is an angled retractor blade that is squared, withintegral ridges to hold tissue aside during use of the retractor.

In one or more embodiments, the blade, the handle and the curved section(referred to herein collectively as “the body”) are integrally molded.In at least one exemplary embodiment, the material of which the body isformed is a strong, rigid, lightweight plastic (e.g., a polymer). Oneexample of a suitable plastic is a glass-fiber reinforced polyarylamidecompound that provides high strength and rigidity, surface gloss, andcreep resistance. An exemplary embodiment uses a 50% glass-fiberreinforced polyarylamide compound, but those skilled in the art willunderstand that other percentages may be used without departing from thespirit and scope of the claimed invention.

Polyarylamides are thermoplastic crystalline polymers of aromaticdiamines and aromatic dicarboxylic anhydrides having good heat, fire,and chemical resistance, property retention at high temperatures,dielectric and mechanical properties, and stiffness but low lightresistance and processability. Those skilled in the art will understandthat other plastics with suitable strength and rigidity also may beused.

In one or more embodiments, the body is made of a plastic (such asglass-fiber reinforced polyarylamide) having properties of at least oneof radiolucence and non-conductivity. As used herein, “radiolucence”means high transparency to radiation, so that the device may be usedwhen taking, for example, x-ray images. “Nonconductive,” as used herein,means essentially dielectric.

An advantage of radiolucence is that the device may be used when takingX-ray images, without obscuring essential structures, as shown in FIG.23 . The “OBP” in FIG. 23 resulted from metal lettering placed below theblades of an embodiment to show the radiolucency. The much darker imageon the left is of a stainless steel comparison blade, which shows up asblack due to its opacity with respect to X-rays.

Embodiments described herein may provide light to the tip of theretractor and still remain highly (as much as 99%) radiolucent. Priorart devices have, for example, fiber optic cables that obstruct the viewwhen X-ray images are taken, even when the devices are constructed ofplastic. Metal devices are, of course, not radiolucent at all.

This radiolucent property means that retractors described herein may notneed to be removed prior to the use of imaging techniques in surgicalprocedures. This can expedite the conduct of a procedure needinganatomic identification and/or device localization.

An advantage of nonconductivity is that it provides improved safety topatients—in contrast to metal retractors. Currents as low as 0.001 A maybe felt by a patient, and larger currents may damage the patient.Embodiments described herein limit currents to less than 10⁻⁶ A, andthus greatly reduce electrical hazards.

For example, electro-cautery is used extensively in surgical tissuedissection. The use of metal retractors exposes the operating surgeonand the patient to the risk of retracted tissue damage due todestructive cautery current being conducted inadvertently. Retractorsare often used to displace and retract delicate cautery sensitivetissues such small or large bowel (colon), lung, or major blood vessels.Cautery injury to these tissues can create major complications. Inaddition, retractors are often used to develop surgical tissue pocketsin breast and pacemaker surgery. Use of a non-electrical conductingmaterial, such as is described herein with respect to certainembodiments, prevents any stray electrical energy injury to theretracted tissues. Patient safety is thus enhanced.

As those skilled in the art will understand, strength is a function ofboth the material and the design. Designs using weaker material than isdescribed herein need to be thicker and more rounded. Both of thesetraits will decrease the favorability of a retractor, which should notblock visibility of the body cavity.

Flexural Strength represents the limit before a material will breakunder stress. Flexural modulus is the tendency of the material to bendunder stress. Both of these parameters are critical to retractor designand resulting performance. First, a retractor blade must be thin enoughto not interfere with the medical procedure for which it is used. Verythick blades will tend to fill the hole in the body that the physicianneeds to work in. An optimal design will have a blade thin enough toallow space for the physician to work. Typically metal blades are usedbecause of their high Flexural modulus. They have unlimited flexuralstrength, because they bend rather than break. Metal blades as thin as0.5-2 mm are readily available and this thickness is small enough to notinterfere with the physician's work space in a wound or operatingcavity. Stainless steel metal can have a flexural modulus of 180 Gpawhich will inhibit blade deformation of more than 10 mm under 15 lbs oftip pressure for most retractor designs.

Plastic injection molded blades require a thicker blade because theyhave a lower Flexural Modulus. Blade strength will increase as the cubeof the blade thickness, but blade thicknesses larger than 2 mm are notdesirable in most physician applications. Typical plastic materials,such as those shown in Table 1 below, have a Flexural Modulus of just afew Gpa and a Flexural Strength of less than 200 Mpa. These lower valueparameters result in retractor blades that deform more than 10 mm underuse, and are likely to break with less than 30 lbs of force placed onthe tip of an average length retractor blade (50-150 mm long).

Retractor blades that deform significantly during use increase thephysician's difficulty in retracting the tissue during a medicalprocedure. Retractor blades that break with less than 30 lbs of forcecan create a hazard to the patient since a broken blade, or pieces of abroken blade, may fall into the patient and create damage. Retractorblades made from the plastics listed in the following table willtypically bend more than 20 mm under 10 lbs of tip force, and will breakat 15 lbs (or even less) of tip force.

TABLE 1 TYPICAL FLEXURAL STRENGTH AND FLEXURAL MODULUS OF POLYMERSFLEXURAL FLEXURAL POLYMER TYPE STRENGTH (MPa) STRENGTH (MPa)Polyamide-lmide 175 5 Polycarbonate 90 2.3 Polyethylene, MDPE 40 0.7Polyethylene 80 1 Terephthalate (PET)

To increase the flexural modulus and flexural strength of plastic, in anembodiment, glass fiber is added to the plastic material. FIG. 24 showsa variety of plastics with various percentages of glass fiber added.

It can be seen from the above that the addition of glass fiber canincrease the Flexural Strength of certain plastics to 300 Mpa or above,and increase the Flexural Modulus to 16 Gpa or above. In an exemplaryembodiment, a certain type of plastic, polyacrylamide, is infused withglass fiber to create a flexural strength of over 375 Gpa and a Flexuralmodulus of over 17 Gpa.

Plastics with these properties have the ability to create retractorblades of approximately 2 mm thickness that withstand over 30 lbs of tipforce without breaking and deform less than 10 mm under 15 lbs of force.Additionally, the glass fiber in this material will “glassify” at thesurface leaving a very smooth “metal like” finish which is highlydesirable in retractor applications.

The glass fiber in the material also will decrease the likelihood ofsharp shards of material being created during an overstress and breakageevent. This tendency to create dull edges upon breakage decreases thelikelihood that a patient will experience damage if the retractor isoverstressed and ultimately broken.

Additionally, the way in which a material breaks can be important inmedical applications. The breakage characteristics of a material areoften measured by Impact Strength. Materials with low impact strength(10-20 J/M) can break under stress into large numbers of sharp shardswhich can pose a hazard to a patient if material failure occurs during amedical procedure. Sharp shards can cut patient tissue and large numbersof these shards can make it difficult or impossible to remove the brokenmaterial from the patient.

Materials (such as glass fiber reinforced polyarylamide) used in certainembodiments described herein have a high impact strength (>100 J/M) andwill fail with very few fractured component edges (and the resultingedges will be blunt). This breakage characteristic minimizes potentialhazard to a patient during product overstress that results in materialbreakage.

FIGS. 25-33 provide views of other exemplary embodiments.

FIGS. 25-27 depict a breast retractor with flanges 2510 at the joint(saddle) between the handle 2530 and blade 2540. The flange sizes aregreatly reduced in comparison to those for the embodiment depicted inFIG. 2 , for example, yet the strength of the retractor has beenmaintained.

FIG. 28 is another view of an exemplary embodiment, with a light/smokeevacuation cover removed. Parallel guides 2810 down the center of theblade and into the saddle hold the LED wires in place. These guides alsostrengthen the joint between the blade and handle so that the retractorremains strong even when the side flanges are dramatically reduced insize to improve physician visibility with angled views.

These wire guide walls are made thicker and higher to add strength tothe curved section that was removed by the reduction of the flanges. Thefirst design (see FIG. 32 ) can withstand over 40 lbs of pressure on thedistal end of the blade. The new reduced flange design (see FIG. 33 )can likewise withstand over 40 lbs of pressure, due to the increasedstructure in the wire guides. The wire guides thus serve two functions:(a) to guide the LED wires, and (b) to add strength to the curvedportion between the handle and blade.

The increased visibility can be seen via comparison of FIGS. 32 and 33 .In the design depicted in FIG. 32 , the effective blocked view is 43.86mm. In the design depicted in FIG. 33 , the effective blocked view is32.39 mm—resulting in a greater than 25% decrease in visual obstruction.The lower part of the saddle portion in each of FIGS. 32-33 is thebarrel end, and the upper part of the saddle portion is the handle end(the topmost portion of each figure depicting a portion of the handle).

When looking at the side of the retractor in FIG. 33 , the effectiveheight of the blade is the distance between the bottom of the blade tothe top of the barrel wall. In general a larger distance will produce astronger blade—i.e., the strength is related to the effective“thickness” of the structure. Because of the leverage created by theblade, any force placed on the distal tip of the blade will create anincreasing stress moving from the distal end to the proximal end. Thatis why the proximal end must have a larger effective structuralthickness than the distal end. The flanges provide this larger effectivethickness.

FIG. 29 depicts an end cap assembly 2910 of an exemplary embodiment. Theend cap may perform LED switching, smoke evacuation, and/or electricalcomponent holding functions. In the depicted embodiment, all threefunctions are performed.

FIG. 30 is a close-up view of an end cap assembly of an exemplaryembodiment. Item 3110 with the tab on the top and bottom is a batteryassembly. The tabs may be made of metal and soldered to the wires asshown (one of the metal tabs soldered to the center leg of the switch).There may be an elastic around the battery assembly that holds it to amolded post during assembly so that the battery assembly does not move.Wires are shown soldered to the metal tab of the battery assembly and toone of the leads of the switch.

FIG. 31 is a view of an exemplary end cap assembly from the other side,showing a switch tab 3110 and smoke evacuation fitting 3120.

FIGS. 34-38 depict a further embodiment of an end cap assembly coupledto a retractor handle or to any other medical device with a hollowhandle. As shown in FIG. 34 , an end cap assembly 3410 incorporates someof the features of the previously-described design, with added featuresof airtight construction, airtight coupling with a retractor handle anduse of a releasable battery door 3420. The releasable battery door 3420is operated to allow one or more batteries held by the end cap assembly3410 to be removed and disposed without the remaining portions of theend cap assembly 3410 being separated from the retractor. In this andother embodiments of the end cap assembly described herein, in order towithstand significant force during use of the retractor, the end capassembly is coupled to the retractor so that the end cap assembly isvery difficult, if not impossible, to remove. Hence, without areleasable battery door, the retractor is disposed, after it is used,together with the end cap assembly still intact and also with thebatteries. However, there is an environmental need for disposing ofbatteries separately from the retractor after use in order to recyclethem, and the embodiment shown in FIGS. 34-38 provides an exemplarysolution by using a releasable battery door, which creates an opening inthe end cap assembly through which the batteries can be dropped anddisposed separately. In this embodiment, the releasable battery door canbe opened easily by a user wearing gloves and the batteries can beremoved from the retractor without the user coming into contact with thebatteries, thus avoiding contamination of the batteries with medicalwaste. In addition, the end cap assembly 3410 includes a suction port3426 which can be connected to a suction or vacuum source to allow forremoval of debris and smoke as described above. The airtightconstruction of the end cap assembly 3410 improves the suction operationand removal of debris and smoke by eliminating air gaps that wouldotherwise cause a reduction in the suction strength.

FIGS. 35A-35B show an internal configuration of the end cap assemblyshown in FIG. 34 . As illustrated in FIG. 34 and FIGS. 35A-35B, the endcap assembly includes an outer cover 3412 having a first, outer-facing,surface 3412 a and a second surface 3412 b opposing the first surfaceand facing the handle of the retractor. As shown in the cross-sectionalview of FIG. 35B and in FIG. 34 , the releasable battery door 3420 isinserted into an opening in the outer cover 3412 and engages with theouter cover 3412. The end cap assembly 3410 also includes an activationdevice, such as an activation switch 3414, and associated circuitry andwiring, with a portion of the activation switch protruding through anopening formed in the releasable battery door 3420. In this illustrativeembodiment, the activation switch 3414 can be moved between an ONposition and an OFF position to turn on and turn off a light source ofthe retractor. In other embodiments, the activation switch 3414 can bein any other suitable form, including, but not limited to a removabletab or a push button.

As further shown in FIGS. 35A-35B, the end cap assembly includes anouter wall structure 3416 and an inner wall structure 3418 extendingoutwardly from the second surface 3412 b of the outer cover 3412. Theouter wall structure 3416 and the inner wall structure 3418 form achannel therebetween which is adapted to receive an end portion of theretractor handle. In this way, when the end cap assembly 3410 is coupledwith the retractor handle, the inner wall structure 3418 and anycomponents held therein are disposed within the retractor handle, whilethe outer wall structure 3416 is disposed outside of the retractorhandle. Secure coupling between the end cap assembly 3410 and theretractor handle is achieved by using one or more latches 3422 providedin the end cap assembly 3410 which are adapted to engage withcorresponding openings formed in the retractor handle. As shown in FIG.35A, the latches 3422 may be disposed in spaces formed between portionsof the inner wall structure 3418. Alternatively, latches 3422 may beincorporated into the inner wall structure 3418, provided they havesufficient flexibility to deform for engagement with the correspondingopenings. For example, the latches 3422 may be formed within the innerwall structure, wherein the inner wall structure has a cutout partiallyaround each latch to provide flexibility. Configuration of the latches3422 and their airtight properties are described herein below withrespect to the embodiment shown in FIGS. 39-43 .

As further shown in FIGS. 35A-35B, the end cap assembly 3410 of thisembodiment includes a battery assembly 3510 held and partially enclosedby the inner wall structure 3418. The battery assembly 3510 includes oneor more batteries for powering a light source of the retractor'sillumination assembly. The batteries that may be used to power the lightsource have been described in reference to previous embodiments andfurther descriptions thereof will be omitted. The battery assembly 3510may also include wiring and circuitry, if necessary for electricallycoupling the batteries to electrically couple with other components ofthe retractor, such as the wires, the activation switch, etc. as shownand described in reference to previous embodiments. In one illustrativeembodiment, the battery assembly 3510 further includes a biasing member,such as a spring 3530, that presses the batteries against the releasablebattery door 3420 to force an electrical connection with an activationswitch 3414 positioned at the other end of the battery assembly 3510and/or to assist in removal of the batteries after the releasablebattery door 3420 is opened or removed from the end cap assembly 3410.

As shown in FIGS. 35A-B, the battery assembly 3510, including thebatteries and the spring 3530, is enclosed or partially enclosed by theinner wall structure 3418 of the end cap assembly 3410. In this way, thebatteries and the spring are held in place by the inner wall structure3418 and are prevented from shifting during use of the retractor. Inthis illustrative embodiment, an electrical connector 3424 is providedin the inner wall structure for electrically connecting the batteriesvia the spring 3510 with one of the wires leading to the light source.In other embodiments, the spring 3510 may be directly coupled with thewire leading to the light source, without the use of a separateelectrical connector.

As can be seen in FIG. 35A, the inner wall structure 3418 also enclosesor partially encloses a region in direction communication with thesuction port 3426. In this embodiment of the end cap assembly, thebattery assembly and the activation switch are disposed to the side ofthis region and do not overlap with the suction port 3426. Thisconfiguration allows for stronger suction without interference fromother components of the end cap assembly. In addition, by placing theone or more batteries in an overlapping relationship to the activationswitch, as described herein below, the end cap assembly is airtight andprevents or reduces air leaks through the opening for the switch. Thisalso improves the suction and removal of debris and smoke during use ofthe retractor. In some embodiments, the battery assembly may be placedso as to partially overlap with the suction port 3426, if needed tocomply with size limitations of the end cap assembly.

FIGS. 36A-36B further illustrate a portion of the end cap assembly 3410that includes the battery assembly 3510, the activation switch 3414 andthe releasable battery door 3420. Specifically, FIGS. 36A-36B show thepositional relationship among the batteries in the battery assembly3510, the activation switch 3414 and the releasable battery door 3420.In the exemplary embodiment shown in FIGS. 36A-36B, the activationswitch 3414 is arranged in the releasable battery door 3420, so that anopening is provided in the releasable battery door 3420 for a switchoperating member 3414 a of the activation switch 3414. In thisillustrative embodiment, the switch operating member 3414 a extendsthrough the opening in the releasable battery door 3420 and can be movedbetween the ON and OFF positions within the opening. As also shown inFIGS. 36A-36B, wiring 3414 b, including wire loops, for the activationswitch 3414 is provided on the internal side of the releasable batterydoor 3420 and is attached to the releasable battery door 3420 by anelectrical connection plate 3424. The wiring 3414 b is electricallycoupled with one of the wires connected to and leading to the lightsource.

The battery assembly 3510 is positioned so that the one or morebatteries abut the electrical connection plate 3424 and/or wiring 3414 bwhen the releasable battery door 3420 is closed. As can be seen in FIGS.36A-36B, the spring 3530 biases the one or more batteries at the otherend in a direction toward the releasable battery door 3420. In this way,an electrical connection is made between the activation switch 3414 andthe one or more batteries via the electrical connection plate 3424and/or the wiring 3414 b and when the releasable battery door 3420 isopened, the batteries are forced out by the biasing force of the spring.Accordingly, without the releasable battery door surface to which thebatteries are pressed against, the batteries will drop loose without anyadditional effort. By placing the batteries over the activation switch3414 provided in the releasable battery door 3420, an airtightconstruction is achieved so that suction through the suction port 3426is not reduced by air leaks through the opening in the releasablebattery door. In addition, such configuration greatly reduces the numberof necessary components to allow for battery disposal via the releasablebattery door.

As shown in FIGS. 36A-36B, the releasable battery door 3420 includes apair of side tabs 3421, each of which extends from a side of thereleasable battery door 3420. Each of the side tabs 3421 includes alatch protrusion 3421 a which is adapted to engage with a correspondingopening 3412 c in the outer cover 3412, which are shown in FIG. 37 .

FIG. 37 shows the end cap assembly 3410 with the releasable battery door3420 removed so as to expose the activation switch 3414. The releasablebattery door 3420 is attached or closed by rotating it relative to theouter cover 3412 which causes the latch protrusions 3412 inserted intothe corresponding openings 3412 c to engage with the outer cover 3412.The outer cover may include corresponding recesses adjacent to theopenings 3412 c to facilitate engagement with the latch protrusions. Theside tabs 3412 of the releasable battery door 3420 make it easy for theuser to rotate the releasable battery door 3420 between the closedposition and the open position. In the illustrative embodiment shown,the releasable battery door 3420 can be removed from the end capassembly 3410 by rotating it about 15 degrees from its original (closed)position. In some other versions, the releasable battery door may beoperated by pressing, pulling, peeling, or breaking, etc. the releasablebattery door. As discussed above, upon removal of the releasable batterydoor, the spring pushes out the batteries contained in the batteryassembly of the end cap assembly, and the batteries are disposed. Inversions where a spring is not used, a user may need to shake or apply asmall force to the retractor to trigger the batteries to drop from thebattery assembly.

FIG. 38 shows an internal view of the releasable battery door 3420 thathas been removed. As described above, the activation switch 3414 isprovided in the releasable battery door 3420, and as shown, the wiringfor the activation switch 3414 b is held by the electrical connectionplate 3424 and attached to the releasable battery door 3420. When thereleasable battery door 3420 is attached to the end cap assembly, thewiring 3414 b for the activation switch is electrically coupled to thewiring leading to the light source of the retractor and is electricallycoupled to the one or more batteries of the battery assembly.

In one version, the releasable battery door 3420 completely detachesfrom the end cap assembly 3410 and is disposed separately. In thisillustrative embodiment, the activation switch and/or the wires used inconjunction with activation switch and the batteries to power the lightsource remain connected to the releasable battery door 3420 and areremoved from the end cap assembly 3410, and the batteries can bedisposed and recycled. In another embodiment, the releasable batterydoor 3420 remains attached to (or remains hanging from) the end capassembly 3410 via a wire, string, a hinge or other suitable technique toallow only the batteries to be disposed separately. In such embodiment,the batteries are disposed without requiring the user to ensure that thereleasable battery door 3420 is not disposed together with thebatteries.

FIGS. 39-43 depict another embodiment of an end cap assembly 3910 inaccordance with the present invention. The construction of the end capassembly 3910 is similar to the construction of the end cap assembly3410 shown in FIGS. 34-38 , with the exception of the releasable batterydoor. Therefore, detailed description of the same or similar componentsof the end cap assembly will be omitted. As in the end cap assembly ofFIGS. 34-38 , the end cap assembly 3910 of this embodiment enables asuction tube to be connected via an end cap suction port 3926. The endcap suction port 3926, when connected with the suction tube, transfersall of the suction up through the handle via a smoke evacuation channeland out to the tip of the retractor. In accordance with this embodimentof the present invention, a number of features are provided on ortogether with the end cap assembly 3910 to maximize the suctionefficiency and/or eliminate or reduce air leakage at or around the endcap assembly 3910 and/or the handle portion of retractor.

In one exemplary embodiment, an outer cover 3912 of the end cap assembly3910 includes two main openings through which air may pass. As shown inFIGS. 39 and 40A-40C, the end cap assembly 3910 includes a first openingwhich connects with the end cap suction port 3926 and a second openingthat is provided for an activation switch 3914 to be controlledexternally. In this embodiment, the end cap assembly 3910 includes abattery assembly 4010 that is positioned directly over the activationswitch and associated circuitry and wiring so as to prevent or reduceair leaks through the second opening in the outer cover 3912. Like theembodiment of the end cap assembly 3410 in FIGS. 34-38 , this embodimentof the end cap assembly 3910 frees up the first opening connected to theend cap suction port for a stronger suction and covers up the secondopening for the activation switch to prevent air leakage therethrough.

As shown in FIG. 40B, one or more batteries of the battery assembly 4010are partially enclosed by an inner wall structure 3918, which alsoencloses or partially encloses a region adjacent to the battery assembly4010 and in communication with the suction port 3926. In thisillustrative embodiment, an internal projection 4018 or an additionalwall structure is provided between the battery assembly and the suctionregion to hold the one or more batteries in place to prevent shifting ormovement of the one or more batteries held by the end cap assembly.

As further shown in FIGS. 40A-40C, the one or more batteries of thebattery assembly 4010 are in direct contact with an electrical contactplate 3924 and in electrical contact with wire loops 3414 b on one sideand in direct and electrical contact with a spring 4030 on the otherside. The spring is generally anchored to a post inside the retractorhandle (not shown) in order to keep it in place. Specifically, thebatteries are firmly pressed up against the electrical contact plate3924 covering the activation switch 3914 so as to provide airtightsealing to the second opening.

In some embodiments, the airtight sealing is further improved byproviding one or more latches 3922 on the end cap assembly 3910 forcoupling the end cap assembly with the retractor handle. As shown inFIG. 41 , the end cap assembly includes at least one latch 3922 moldedthereon, and as in the embodiment of FIGS. 34-38 , the one or morelatches 3922 are provided between portions of the inner wall structure3918 or may be incorporated into the inner wall structure 3918. The oneor more latches 3922 on the end cap assembly 3910 are adapted to engagewith one or more corresponding openings 4210 provided in the retractorhandle shown in FIG. 42 . In certain embodiments, molding of the latches3922 requires formation of cutouts in the outer cover 3912 of the endcap assembly 3910, which are visible in FIG. 39 , so that the mold cancreate the bottom portion of the latches. These cutouts are filled byrespective protrusions 4220, shown in FIG. 42 , which are provided onthe bottom of the retractor handle. FIG. 43 shows a cross sectional viewof the end cap assembly 3910 engaged with the retractor handle toillustrate the coupling between the end cap assembly 3910 and theretractor handle.

The construction of each latch 3922 shown in FIG. 41 also promotesairtightness when the end cap assembly 3910 is engaged with theretractor handle. Specifically, the latch 3922 comprises a post 3923with a protrusion 3923 a formed on its outward facing surface, whereinthe protrusion 3923 a has a smaller width and extends to a smallerheight than the respective width and height of the post 3923. That is,the span of the post 3923 in the width direction and in the heightdirection is greater than the span of the protrusion 3923 a so that theouter edge of the post 3923 forms a flange. In addition, the span of thepost in the width and height direction is greater than the span of thecorresponding opening in the retractor handle. In this way, when theprotrusion 3923 a is engaged with the corresponding opening 4210 in theretractor handle, the flange, which extends beyond the width and heightof the protrusion 3923 a, overlaps with any openings that may be formedaround the area of engagement between the protrusion 3923 a and theopening 4210. In this way, any possible air leaks through the openings4210 in the handle are reduced or eliminated.

The end cap assemblies of FIGS. 34-43 are used with an illuminatedsurgical retractor that includes a smoke evacuation feature and provideairtight coupling with a vacuum source so as to provide more efficientsuction to remove debris and smoke from the operating end during use. Itis also contemplated that these and similar end cap assemblies may beused with other medical devices, such as suction devices and other typesof instruments, that have a hollow handle and require airtight provisionof suction.

It should be understood that the foregoing relates to exemplaryembodiments of the invention and that modifications may be made withoutdeparting from the spirit and scope of the claimed invention.

I claim:
 1. A medical device, comprising: a handle portion connected toan operative portion at a proximal end thereof, the handle portionhaving a hollow cross-section and an open distal end; an illuminationassembly comprising at least one light source, a switch assembly forenergizing the light source, and at least one battery for powering thelight source; an end cap assembly configured to attach to the opendistal end of the handle portion, the end cap assembly accommodating theswitch assembly and being configured to hold the at least one batterywithin the handle and to partially enclose the at least one battery; anda smoke evacuation channel in communication with the hollowcross-section of the handle, wherein a portion of the switch assemblyextends through an opening in the end cap assembly and the at least onebattery is held by the end cap assembly to overlap with the switchassembly and to overlap with the opening in the end cap assembly, andwherein the end cap assembly includes a vacuum port configured to coupleto a vacuum source and to provide suction to the smoke evacuationchannel through the handle.
 2. The medical device of claim 1, whereinthe at least one battery is held by the end cap assembly so as to notoverlap with the vacuum port.
 3. The medical device of claim 1, whereinthe end cap assembly comprises: an outer cover having a first surfacefacing outwardly and an opposing second surface, wherein the opening andthe vacuum port are formed in the outer cover; an outer wall structureformed on the second surface of the outer cover; and an inner wallstructure formed on the second surface of the outer cover, the outerwall structure and the inner wall structure forming a channeltherebetween configured to receive the open distal end of the handle. 4.The medical device of claim 1, wherein the end cap assembly comprises anouter cover having a first surface facing outwardly and an opposingsecond surface, and a wall structure extending transversely from thesecond surface of the outer cover, said wall structure partiallyenclosing the at least one battery.
 5. The medical device of claim 1,wherein the end cap assembly further comprises at least one latch forengaging with a corresponding opening formed in the handle, and whereinthe at least one latch is configured so as to prevent or reduce airleakage through the corresponding opening in the handle.
 6. The medicaldevice of claim 5, wherein each latch comprises a post and a protrusionformed on a surface of the post and wherein a span of the post isgreater than a span of the protrusion and greater than a span of thecorresponding opening in the handle.
 7. The medical device of claim 1,wherein the end cap assembly comprises a releasable battery doorcovering a second opening formed in the end cap assembly and configuredto enable removal of the at least one battery from the medical device.8. The medical device of claim 7, wherein the switch assembly isdisposed adjacent the releasable battery door and the portion of theswitch assembly extends through the opening formed in the releasabledoor.
 9. A battery-operated medical device comprising: a handle portionconnected to an operative portion at its proximal end and having ahollow cross-section and an open distal end; a power source housedwithin the handle portion; an end cap assembly sealingly coupled to theopen distal end of the handle portion so as to prevent or reduce airleakage around the end cap assembly, the end cap assembly holding andpartially enclosing the power source within the handle, wherein the endcap assembly includes a vacuum port configured to couple to a vacuumsource and to interact with a suction channel in the handle to providesuction through the handle.
 10. The battery-operated medical device ofclaim 9, wherein the end cap assembly includes an outer cover configuredto cover the open distal end of the handle portion, the outer coverincluding an opening formed therein for removal of the power source fromthe illuminated retractor and a releasable door configured to cover theopening.
 11. The battery-operated medical device of claim 10, whereinthe power source held by the end cap assembly abuts the releasable door.12. The battery-operated medical device of claim 10, further including aswitch assembly, wherein a portion of the switch assembly is disposedadjacent the releasable door and the power source held by the end capassembly abuts the switch assembly.
 13. The battery-operated medicaldevice of claim 9, further comprising a smoke evacuation channelprovided on the operative portion and in communication with the hollowcross-section of the handle, wherein the vacuum port in the end capassembly is configured to provide suction to the smoke evacuationchannel through the suction channel in the handle.
 14. Abattery-operated medical device comprising: a handle portion connectedto an operative portion at its proximal end and having a hollowcross-section and an open distal end; an end cap assembly partiallyinserted into the open distal end of the handle portion and sealinglycoupled to the distal end of the handle portion; a power source housedwithin the handle portion; a switch assembly accommodated within the endcap assembly, said power source overlapping with the switch assembly ina direction along a longitudinal axis of the handle portion; and asuction channel in communication with the hollow cross-section of thehandle portion, wherein the end cap assembly includes a vacuum portconfigured to couple to a vacuum source and to provide suction to thesuction channel through the handle, said vacuum port being offset fromthe power source and the switch assembly in a direction transverse tothe longitudinal axis of the handle portion.
 15. The battery-operatedmedical device in accordance with claim 14, wherein the vacuum port isnot obstructed by the power source and the switch assembly.
 16. Thebattery-operated medical device in accordance with claim 14, wherein theend cap assembly is configured to prevent or reduce air leakage aroundthe end cap assembly.
 17. The battery-operated medical device inaccordance with claim 14, wherein the end cap assembly includes an outercover configured to cover the open distal end of the handle portion, andone or more inner wall structures protruding from the outer cover, saidone or more inner wall structures are configured to be inserted into thehandle and to partially enclose the power source.
 18. Thebattery-powered medical device in accordance with claim 17, wherein aportion of the switch assembly protrudes through an opening in the outercover and the power source overlaps with the opening in the outer cover.19. The battery-powered medical device in accordance with claim 17,wherein the end cap assembly includes at least one outer wall structure,said inner and outer wall structures protruding from the same surface ofthe outer cover and forming a channel therebetween for accommodating thedistal end of the handle portion.
 20. The battery-powered medical devicein accordance with claim 14, wherein the medical device is a retractorincluding an illumination assembly.